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1.
Clinical data adequate for analysis were available in 386 laboratory-confirmed cases of arthropod-borne encephalitis - 38 St. Louis and 348 western equine. Consistently observed symptoms varied with the age of the patient. Symptoms that occurred in a high proportion of patients in each age group were:LESS THAN ONE YEAR OF AGE: Fever and convulsions. (None had the St. Louis disease.)ONE THROUGH FOUR YEARS: Fever, headache, vomiting, drowsiness, irritability, restlessness, nuchal rigidity, tremor, and sometimes convulsions. FIVE THROUGH FOURTEEN YEARS: Headache, fever, and drowsiness. Sometimes the disease progressed no further, but if it did, nausea, vomiting, muscular pain, photophobia and limitation of neck and back flexion often were noted; and sometimes convulsions and intention tremors. FIFTEEN YEARS AND OLDER: Drowsiness, lethargy, malaise, fever, stiffness at the back of the neck and, almost always, severe intractable occipital headache associated with nausea, disturbance of vision, photophobia and vertigo. The extreme difficulty of differential diagnosis on the basis of clinical observation was indicated by the wide range of diagnoses made in these cases before the invading organism was identified by laboratory studies. 相似文献
2.
In a clinical review of 50 cases of western equine and 16 cases of St. Louis encephalomyelitis in humans it was noted that fever, headache, lethargy, drowsiness, tremor and stiffness of the neck were the most frequent signs or symptoms initiating the illness. The great majority of patients recovered without residual effect. These two diseases of the central nervous system can only be differentiated on an immunological basis but may be suspected during seasonal periods in geographical areas where these virus infections are known to exist. Neuropathological studies were done in four cases of human western equine and two cases of St. Louis encephalomyelitis. The primary point of attack by the virus is the cell body, the lesions being concentrated in the striate body, diencephalon, the brain stem and cerebellum. All histo-anatomical findings (nerve cell destruction, microglial nests, small isolated and confluent areas of necrosis and perivascular round cell infiltration) are secondary to the injury of the nerve cell body caused by the neurotropic virus. 相似文献
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4.
《Microbes and infection / Institut Pasteur》2015,17(10):671-675
An outbreak of unexplained and severe kidney disease, “Mesoamerican Nephropathy,” in mostly young, male sugar cane workers emerged in Central America in the late 1990's. As a result, an estimated 20,000 individuals have died, to date. Unfortunately, and with great consequence to human life, the etiology of the outbreak has yet to be identified. The sugarcane fields in Chichigalpa, Chinandega, Nicaragua, have been involved in the outbreak, and during our initial investigation, we interviewed case patients who experienced fever, nausea and vomiting, arthralgia, myalgia, headache, neck and back pain, weakness, and paresthesia at the onset of acute kidney disease. We also observed a heavy infestation of rodents, particularly of Sigmodon species, in the sugarcane fields. We hypothesize that infectious pathogens are being shed through the urine and feces of these rodents, and workers are exposed to these pathogens during the process of cultivating and harvesting sugarcane. In this paper, we will discuss the epidemic in the Chichigalpa area, potential pathogens responsible for Mesoamerican Nephropathy, and steps needed in order to diagnose, treat, and prevent future cases from occurring. 相似文献
5.
In a study of almost 500 patients to determine residual effects, the sequelae of both St. Louis and Western equine encephalitis were more prominent in the younger age group. Infants under three months with Western equine encephalitis had the greatest central nervous system damage. Forty-four per cent of this entire group had sequelae.In patients between one and four years of age, the incidence of sequelae was less. The Western equine infection was associated with the more disabling residual damage. Postencephalitic convulsions were fairly common in the younger patients with Western equine disease, but not in the St. Louis group. After the age of five the sequelae rate dropped. In all age groups the Western equine residual changes were more severe than the damage of St. Louis infection.Some infants, children and adults showed remarkable improvement from sequelae even as much as two years after the abnormalities occurred.With the longer period of follow-up, some late sequelae were noted in children and adults, primarily among those who had Western equine infection. 相似文献
6.
In a study of almost 500 patients to determine residual effects, the sequelae of both St. Louis and Western equine encephalitis were more prominent in the younger age group. Infants under three months with Western equine encephalitis had the greatest central nervous system damage. Forty-four per cent of this entire group had sequelae. In patients between one and four years of age, the incidence of sequelae was less. The Western equine infection was associated with the more disabling residual damage. Postencephalitic convulsions were fairly common in the younger patients with Western equine disease, but not in the St. Louis group. After the age of five the sequelae rate dropped. In all age groups the Western equine residual changes were more severe than the damage of St. Louis infection. Some infants, children and adults showed remarkable improvement from sequelae even as much as two years after the abnormalities occurred. With the longer period of follow-up, some late sequelae were noted in children and adults, primarily among those who had Western equine infection. 相似文献
7.
Arthur C. Hollister Jr. W. Allen Longshore Jr. B. H. Dean Ida May Stevens 《The Western journal of medicine》1953,79(2):84-90
For the most part, epidemiologic phenomena observed in the outbreak of encephalitis in 1952 accorded with patterns that had been apparent in previous years. Ninety-seven per cent of the 414 laboratory-confirmed cases of western equine and St. Louis encephalitis in humans occurred in the 20 Central Valley counties. The cases of western equine encephalomyelitis in horses were generally scattered over the state. In the Central Valley most of the cases in horses were in animals less than two years of age; elsewhere the incidence was higher in older horses.There were no laboratory-confirmed cases of western equine or St. Louis encephalitis in humans earlier than June or later than October.In 1952 there were far more cases of western equine than of St. Louis encephalitis—a departure from the pattern in the previous seven years when there were about as many of one as of the other. No known satisfactory index is available for the prediction of the extent or type of outbreaks in humans.Approximately one-third of the cases of western equine encephalitis were in patients less than one year of age, whereas there were no cases of the St. Louis disease in patients that young.The incidence of western equine encephalitis in persons under 5 years of age was about the same for girls as for boys. In higher age brackets, males with western equine encephalitis outnumbered females 2 to 1. The corresponding ratio for St. Louis encephalitis was only 1.2 to 1. 相似文献
8.
For the most part, epidemiologic phenomena observed in the outbreak of encephalitis in 1952 accorded with patterns that had been apparent in previous years. Ninety-seven per cent of the 414 laboratory-confirmed cases of western equine and St. Louis encephalitis in humans occurred in the 20 Central Valley counties. The cases of western equine encephalomyelitis in horses were generally scattered over the state. In the Central Valley most of the cases in horses were in animals less than two years of age; elsewhere the incidence was higher in older horses.There were no laboratory-confirmed cases of western equine or St. Louis encephalitis in humans earlier than June or later than October. In 1952 there were far more cases of western equine than of St. Louis encephalitis-a departure from the pattern in the previous seven years when there were about as many of one as of the other. No known satisfactory index is available for the prediction of the extent or type of outbreaks in humans. Approximately one-third of the cases of western equine encephalitis were in patients less than one year of age, whereas there were no cases of the St. Louis disease in patients that young.The incidence of western equine encephalitis in persons under 5 years of age was about the same for girls as for boys. In higher age brackets, males with western equine encephalitis outnumbered females 2 to 1. The corresponding ratio for St. Louis encephalitis was only 1.2 to 1. 相似文献
9.
During the summer and fall of 1969 an outbreak of aseptic meningitis occurred in Montreal and its environs. Forty-four patients were admitted to the infectious disease ward of The Montreal Children''s Hospital in August, September and October. Half of the patients were in the age group 6 to 10 years. The ratio of males to females was two to one. Patients showed the typical signs and symptoms of aseptic meningitis, namely fever, vomiting, headache, neck stiffness and pleocytosis of the cerebrospinal fluid.Viruses were recovered from 19 (43%) of the 44 cases. The predominant virus in the outbreak was a non-hemagglutinating strain of echovirus 6. Other virus types isolated in the outbreak were echovirus 7, coxsackievirus A9 and coxsackievirus B4. Serological investigations confirmed the validity of the echovirus isolations and identified additional cases. 相似文献
10.
T. O. Mulligan 《BMJ (Clinical research ed.)》1971,4(5788):665
One hundred and fifty cases of typhoid in infants and young children are reported. In children over 5 years of age the features resembled those in adults, but in those under this age they were often nonspecific including fever, convulsions, diarrhoea, and vomiting. Attention is drawn to the importance of a blood culture in anaemic afebrile children who develop rigors and high fever after blood transfusions. 相似文献
11.
降钙素基因相关肽与偏头痛关系的研究 总被引:2,自引:0,他引:2
偏头痛是临床上常见的多发性疾病,主要表现为一侧或双侧头部反复发作的搏动性疼痛,可伴有恶心、呕吐、视物异常等神经症状。关于偏头痛的发病机制研究尚无定论。偏头痛的发病机理一直受到人们的关注,近年来一些研究表明,偏头痛的发作与头颅血管周围组织产生的血管活性物质,特别是与三叉神经血管系统的降钙素基因相关肽(calcitonin gene-relatedpeptide,CGRP)的含量变化关系密切。 相似文献
12.
We analyzed prospectively 326 laboratory-confirmed, uncomplicated malarial infections (46.3% due to Plasmodium vivax, 35.3% due to P. falciparum, and 18.4% mixed-species infections) diagnosed in 162 rural Amazonians aged 5-73 years. Thirteen symptoms (fever, chills, sweating, headache, myalgia, arthralgia, abdominal pain, nausea, vomiting, dizziness, cough, dyspnea, and diarrhea) were scored using a structured questionnaire. Headache (59.8%), fever (57.1%), and myalgia (48.4%) were the most frequent symptoms. Ninety-six (29.4%) episodes, all of them diagnosed during cross-sectional surveys of the whole study population (96.9% by molecular technique only), were asymptomatic. Of 93 symptom-less infections left untreated, only 10 became symptomatic over the next two months following diagnosis. Fever was perceived as " intense " in 52.6% of 230 symptomatic malaria episodes, with no fever reported in 19.1% episodes although other symptoms were present. We found significant differences in the prevalence and perceived intensity of fever and other clinical symptoms in relation to parasite load at the time of diagnosis and patient's age, cumulative exposure to malaria, recent malaria morbidity, and species of malaria parasite. These factors are all likely to affect the effectiveness of malaria control strategies based on active or passive detection of febrile subjects in semi-immune populations. 相似文献
13.
摘要 目的:比较托烷司琼与帕洛诺司琼用于小儿骨科术后镇痛时预防恶心呕吐的效果。方法:纳入2019年3月到2021年3月在我院进行骨科手术的儿童60例,根据术后镇痛泵中使用止吐药物的不同分为托烷司琼组和帕洛诺司琼组,每组30例,比较两组患儿术前、术后的心率(HR)、平均动脉压(MAP),在术后48小时内,观察两组患儿恶心呕吐、头晕头痛、皮肤瘙痒以及呼吸抑制等术后并发症。视觉模拟评分法(VAS)评估患儿术后疼痛,Ramsay量表评估患儿术后镇静效果。结果:托烷司琼和帕洛诺司琼组患儿在术前和术后HR和MAP比较均无显著差异(P>0.05);托烷司琼组和帕洛诺司琼组患儿术后VAS评分、Ramsay评分均随时间延长而降低,且同一时间点两组患儿VAS评分无显著差异(P>0.05);帕洛诺司琼组术后PONV发生率(20.00 %)高于托烷司琼组(3.33 %)(P<0.05)。帕洛诺司琼组和托烷司琼组患儿出现头晕头痛、皮肤瘙痒以及呼吸抑制例数分别为3/2例、1/0例和1/0例。两组间术后并发症发生率比较无差异(P>0.05)。结论:托烷司琼与帕洛诺司琼对骨科手术后儿童血流动力学、疼痛和镇静效果并无差异,但在预防术后恶心呕吐方面托烷司琼效果优于帕洛诺司琼。 相似文献
14.
Nyholt DR Morley KI Ferreira MA Medland SE Boomsma DI Heath AC Merikangas KR Montgomery GW Martin NG 《American journal of human genetics》2005,77(3):500-512
Familial typical migraine is a common, complex disorder that shows strong familial aggregation. Using latent-class analysis (LCA), we identified subgroups of people with migraine/severe headache in a community sample of 12,245 Australian twins (60% female), drawn from two cohorts of individuals aged 23-90 years who completed an interview based on International Headache Society criteria. We report results from genomewide linkage analyses involving 756 twin families containing a total of 790 independent sib pairs (130 affected concordant, 324 discordant, and 336 unaffected concordant for LCA-derived migraine). Quantitative-trait linkage analysis produced evidence of significant linkage on chromosome 5q21 and suggestive linkage on chromosomes 8, 10, and 13. In addition, we replicated previously reported typical-migraine susceptibility loci on chromosomes 6p12.2-p21.1 and 1q21-q23, the latter being within 3 cM of the rare autosomal dominant familial hemiplegic migraine gene (ATP1A2), a finding which potentially implicates ATP1A2 in familial typical migraine for the first time. Linkage analyses of individual migraine symptoms for our six most interesting chromosomes provide tantalizing hints of the phenotypic and genetic complexity of migraine. Specifically, the chromosome 1 locus is most associated with phonophobia; the chromosome 5 peak is predominantly associated with pulsating headache; the chromosome 6 locus is associated with activity-prohibiting headache and photophobia; the chromosome 8 locus is associated with nausea/vomiting and moderate/severe headache; the chromosome 10 peak is most associated with phonophobia and photophobia; and the chromosome 13 peak is completely due to association with photophobia. These results will prove to be invaluable in the design and analysis of future linkage and linkage disequilibrium studies of migraine. 相似文献
15.
Petra van den Doel Asisa Volz Jouke M. Roose Varsha D. Sewbalaksing Gorben P. Pijlman Ingeborg van Middelkoop Vincent Duiverman Eva van de Wetering Gerd Sutter Albert D. M. E. Osterhaus Byron E. E. Martina 《PLoS neglected tropical diseases》2014,8(9)
Chikungunya virus (CHIKV) infection is characterized by rash, acute high fever, chills, headache, nausea, photophobia, vomiting, and severe polyarthralgia. There is evidence that arthralgia can persist for years and result in long-term discomfort. Neurologic disease with fatal outcome has been documented, although at low incidences. The CHIKV RNA genome encodes five structural proteins (C, E1, E2, E3 and 6K). The E1 spike protein drives the fusion process within the cytoplasm, while the E2 protein is believed to interact with cellular receptors and therefore most probably constitutes the target of neutralizing antibodies. We have constructed recombinant Modified Vaccinia Ankara (MVA) expressing E3E2, 6KE1, or the entire CHIKV envelope polyprotein cassette E3E26KE1. MVA is an appropriate platform because of its demonstrated clinical safety and its suitability for expression of various heterologous proteins. After completing the immunization scheme, animals were challenged with CHIV-S27. Immunization of AG129 mice with MVAs expressing E2 or E3E26KE1 elicited neutralizing antibodies in all animals and provided 100% protection against lethal disease. In contrast, 75% of the animals immunized with 6KE1 were protected against lethal infection. In conclusion, MVA expressing the glycoprotein E2 of CHIKV represents as an immunogenic and effective candidate vaccine against CHIKV infections. 相似文献
16.
Michelle M. Thiboutot Senthil Kannan Omkar U. Kawalekar Devon J. Shedlock Amir S. Khan Gopalsamy Sarangan Padma Srikanth David B. Weiner Karuppiah Muthumani 《PLoS neglected tropical diseases》2010,4(4)
Chikungunya virus is a mosquito-borne emerging pathogen that has a major health impact in humans and causes fever disease, headache, rash, nausea, vomiting, myalgia, and arthralgia. Indigenous to tropical Africa, recent large outbreaks have been reported in parts of South East Asia and several of its neighboring islands in 2005–07 and in Europe in 2007. Furthermore, positive cases have been confirmed in the United States in travelers returning from known outbreak areas. Currently, there is no vaccine or antiviral treatment. With the threat of an emerging global pandemic, the peculiar problems associated with the more immediate and seasonal epidemics warrant the development of an effective vaccine. In this review, we summarize the evidence supporting these concepts. 相似文献
17.
For many years it was generally believed that all convulsions associated with exanthem subitum were febrile in origin. More recently several investigators have suggested that the causative agent of this disease has a selective action on brain tissue aside from the effect of high temperature. In support of this concept are a variety of neurological manifestations sometimes observed during the course of exanthem subitum. These include prolonged and repeated convulsions, hemiparesis, headache, vomiting, bulging fontanelle, vertigo, cervical rigidity, extreme irritability and a reversal of the time of sleep. Abnormalities in the spinal fluid have been reported on a few occasions.By chance the authors observed a case of exanthem subitum that began with a prolonged and severe afebrile convulsion and transient left hemiparesis. Serial electroencephalograms showed a focal lesion with suppression and slowing in the right parietal area. Behavior disorders of brief duration were noted. This case is interpreted as additional evidence of the presence of an encephalitic process.The nature of the cerebral lesion remains unknown. The remote possibility of disturbed behavior in later life deserves consideration. 相似文献
18.
Jairo Lizarazo Patricia Escandón Clara Inés Agudelo Elizabeth Casta?eda 《Memórias do Instituto Oswaldo Cruz》2014,109(6):797-804
Cryptococcosis is reported in adults and is often acquired immune deficiency syndrome
(AIDS)-associated; however, its frequency in children is low. Based on the National
Survey on Cryptococcosis conducted in Colombia, an epidemiological and clinical
analysis was performed on cases of the disease observed in children less than 16
years old between 1993-2010. We found 41 affected children (2.6% prevalence) from the
1,578 surveys received. The country mean annual incidence rate was 0.017
cases/100,000 children under 16 years, while in Norte de Santander the incidence rate
was 0.122 cases/100,000 (p < 0.0001). The average age of infected children was 8.4
and 58.5% were male. In 46.3% of cases, a risk factor was not identified, while 24.4%
had AIDS. The most frequent clinical manifestations were headache (78.1%), fever
(68.8%), nausea and vomiting (65.6%), confusion (50%) and meningeal signs (37.5%).
Meningitis was the most frequent clinical presentation (87.8%). Amphotericin B was
given to 93.5% of patients as an initial treatment. Positive microbiological
identification was accomplished by India ink (94.7%), latex in cerebrospinal fluid
(100%) and culture (89.5%). Out of 34 isolates studied, Cryptococcus neoformans var.
grubii (VNI 85.3%, VNII 8.8%) was isolated in 94.1% of cases and Cryptococcus gattii
(VGII) was isolated in 5.9% of cases. These data are complemented by a literature
review, which overall suggests that cryptococcosis in children is an unusual event
worldwide. 相似文献
19.
Sirivichayakul C Limkittikul K Chanthavanich P Jiwariyavej V Chokejindachai W Pengsaa K Suvannadabba S Dulyachai W Letson GW Sabchareon A 《PLoS neglected tropical diseases》2012,6(2):e1520
Background
Dengue infection is one of the most important mosquito-borne diseases. More data regarding the disease burden and the prevalence of each clinical spectrum among symptomatic infections and the clinical manifestations are needed. This study aims to describe the incidence and clinical manifestations of symptomatic dengue infection in Thai children during 2006 through 2008.Study Design
This study is a school-based prospective open cohort study with a 9,448 person-year follow-up in children aged 3–14 years. Active surveillance for febrile illnesses was done in the studied subjects. Subjects who had febrile illness were asked to visit the study hospital for clinical and laboratory evaluation, treatment, and serological tests for dengue infection. The clinical data from medical records, diary cards, and data collection forms were collected and analyzed.Results
Dengue infections were the causes of 12.1% of febrile illnesses attending the hospital, including undifferentiated fever (UF) (49.8%), dengue fever (DF) (39.3%) and dengue hemorrhagic fever (DHF) (10.9%). Headache, anorexia, nausea/vomiting and myalgia were common symptoms occurring in more than half of the patients. The more severe dengue spectrum (i.e., DHF) had higher temperature, higher prevalence of nausea/vomiting, abdominal pain, rash, diarrhea, petechiae, hepatomegaly and lower platelet count. DHF cases also had significantly higher prevalence of anorexia, nausea/vomiting and abdominal pain during day 3–6 and diarrhea during day 4–6 of illness. The absence of nausea/vomiting, abdominal pain, diarrhea, petechiae, hepatomegaly and positive tourniquet test may predict non-DHF.Conclusion
Among symptomatic dengue infection, UF is most common followed by DF and DHF. Some clinical manifestations may be useful to predict the more severe disease (i.e., DHF). This study presents additional information in the clinical spectra of symptomatic dengue infection. 相似文献20.
Five cases of spontaneous intracerebellar hemorrhage are reported. Three had a vascular malformation and two had mild hypertension. The presenting symptom was sudden headache followed by nausea and vomiting. Signs of brain stem dysfunction without prominent cerebellar deficit were the commonest feature. Meningeal involvement was present in the majority of cases. Unsuspected sudden death can occur. It is suggested that patients below the age of 30 who present with sudden headache followed by brain stem dysfunction with or without a subarachnoid hemorrhage, and patients over the age of 45 who present this picture along with subarachnoid hemorrhage should be investigated urgently with contrast studies for possible cerebellar hemorrhage. 相似文献